An NHS decision to move children’s cancer services for South London and South East England to one location has been criticised by thousands of parents and carers, who say it could add hours onto journey times and put children at risk. Some parent campaigners who have worked on the proposals also say they feel their input has been ignored by the NHS.
The decision, which followed a lengthy consultation, now means specialist children’s cancer treatment services at The Royal Marsden Hospital, in Sutton, and St George’s Hospital, Tooting, will be moved to the Evelina Children’s Hospital in Lambeth at an estimated cost of £40m.
It comes after a new national service specification in 2021 outlined that specialist children’s cancer treatment services must be on the same site as a paediatric intensive care unit and other specialist children’s services. The Royal Marsden does not have a paediatric intensive care unit on site, meaning a small number of children with cancer requiring intensive care are transferred safely by ambulance from the hospital to St George’s every year.
According to the NHS: “Evelina’s wide range of services, support for hospitals across its catchment area to look after poorly young patients and strong performance in research are just some of the factors that showed it is the right place for the future Children’s Cancer Centre.”
However, parents and campaigners believe this decision has largely ignored the patient experience, which they believe to be a strength of the current model. Jenny Houghton’s 14-year-old son Lewis was diagnosed with cancer just before his sixth birthday in 2015 and treated at The Royal Marsden. He has been in remission for eight years. Ms Houghton is part of the parent stakeholder group opposing the proposals, which has been involved in the consultation process since 2019.
The 45-year-old told the Local Democracy Reporting Service (LDRS) that the Marsden is ‘incomparable’ and provided world-class care for children. She also highlighted that all families can live on-site at the Marsden, which is important as parents remain the primary carers throughout a child’s time spent at the hospital.
At Evelina, most parents will have to stay at Ronald McDonald House accommodation 10 minutes away from the hospital. Houghton said ‘this was not a solution’, because parents need to be with their children throughout this sensitive process.
She also insisted their campaign was not ‘belittling the impact of this decision if you have a child that needs intensive care’. However, she added: “There are no fatalities from the system that currently works with the Royal Marsden and St George’s. It’s the wrong decision and it’s really disappointing.”
Travel and access to the sites have also been raised by the parents throughout the campaign. The ‘experts by experience’ group which Houghton is a part of, believes the decision to move services will be detrimental to a large number of children and parents who rely on using cars to access treatment.
Along with South London, these changes also cover Kent, most of Surrey, Medway, East Sussex, Brighton and Hove. According to the parent group, 60% of patients are from these areas outside of London and mainly rely on cars for transport.
James Woodall, whose child was also treated at the Royal Marsden, told the LDRS: “A child with cancer is likely to be immunosuppressed, meaning they have a weak immune system, so you don’t want them to go around the general public. I’ve never met anyone that has taken a child to any of the hospitals in anything else than a car.”
Houghton added: “Parents are also advised by the consultant not to take their children on public transport because if they become ill they can’t have their treatment. They have no immune system and if they catch something, that then delays their chemotherapy treatment further.
“Now they tell us if they get a train to the Evelina it might be quicker, but no one is going to do that. Then they come back and say that public transport isn’t great to the Royal Marsden but then you can drive and you have got a car park.”
At the meeting at Wellington House, bosses also decided to move radiotherapy services to University College Hospital (UCH) in Central London. The parents’ group were keen to tell the LDRS that this ‘doesn’t fix the problem’ and that continued travel between Evelina and UCH will need to take place as most children with cancer require radiotherapy.
This concern over transport was shared by Kingston Upon Thames Councillor Anita Schaper, who has been against the proposal from the beginning. She told the LDRS: “Travel and access is a huge problem. From our evidence, we know that the most common childhood cancer from the ages of 0-4 is leukaemia. They are not going to take public transport, it’s a good 20-minute walk from Waterloo.
“No amount of mitigation will ever address that families with very sick immune depressed children will not want to take public transport. The parents and everyone in the feedback have clearly said that.”
Despite being included throughout the process, many parents felt their concerns were not reflected in the decision and believed that their input was akin to a ‘tick box exercise’.
Dr Chris Streather, a senior paediatrician who previously worked as a consultant at St George’s, admitted that the decision will disproportionately impact people across the South East. Speaking to the LDRS he said this decision could benefit those who have good transport links to the Evelina but not those who are poorly connected. However, he was keen to stress that transport and access was ‘absolutely not a trivial thing’ and added that parents and families will receive free parking as a result.
In his official statement, he said: “This is a positive step forward for children’s cancer care – at the new location, children who need intensive care will be able to get it on site and the future centre will stand ready to give cutting-edge treatments that require intensive care on site, like other major centres worldwide.
“Service reconfiguration is rarely easy, but the decision taken today will ensure that children with cancer in South London and much of the South East will continue to receive the best possible care now and into the future.”
A spokesperson for Evelina London Children’s Hospital, part of Guy’s and St Thomas’ NHS Foundation Trust said: “We welcome NHS England’s decision to select Evelina London Children’s Hospital as the future location for very specialist cancer treatment services for children living in south London and much of south east England.
“Throughout the NHS England-led process we have provided detailed evidence to show how Evelina London is best placed to provide high quality care, research and support to children and young people with cancer.
“Bringing together staff from the current Principal Treatment Centre, including the world-renowned team from The Royal Marsden, with the many specialist teams at Evelina London who already care for children with complex medical conditions, will provide joined up and innovative care for children with cancer, in family-friendly facilities. Locating the Principal Treatment Centre at a dedicated specialist children’s hospital will also bring our region into line with children’s cancer care delivery in the rest of England.
“We remain fully committed to working with patients, their families, staff from the current service, and other partners to design the new service with children, young people and staff at its heart, to ensure continuity of care during the transition period and to agree a plan for the transfer of the service.”
The campaign against the plans attracted support from politicians, professionals and celebrities like Jack Dee. The #hearthemarsdenkids petition, set up by Houghton, was eventually signed by 12,000 people.
Wandsworth Council Leader Simon Hogg, who has led Wandsworth’s campaign to save children’s cancer care at St George’s, said: “This is a hugely disappointing decision, and shows that little attention has been paid to the families of children with cancer, who have overwhelmingly voiced their opposition to these proposals.
“St George’s has been offering high-quality cancer care to children for the past 25 years. The removal of services risks losing that clinical expertise and could have a serious knock-on effect on other specialist treatments the hospital provides.
“Our fight to keep children’s cancer care at St George’s does not end here. We will do everything in our power to make sure the NHS and government reconsider this decision and do what is best for families.”
This echoes similar calls by Sutton MPs Elliot Colburn and Paul Scully, who said: “We believe that the Secretary of State for Health and Care should look to use her call-in powers to take a decision on the future of children”s cancer services in SW London and Surrey.”
The NHS plans for the service reconfiguration to commence no earlier than October 2026, but has acknowledged this date may have to be extended. Issues relating to transferring and possibly hiring new staff at the Evelina, along with the building of new facilities may lead to further delay and increased costs.
However, Councillor Schaper said: “At the end of the day there are so many unknown variables and unknown factors out of the NHS’s control, I would be very surprised if it was done in two and a half years, I believe we’re looking at a really slow and painful process of change.”
While NHS bosses praised the work of the Royal Marsden and St George’s, they said the decision was necessary and insisted they ‘will work hard to ensure they we deliver the best patient experience that we can’.
Photos:
Jenny and Steve Houghton with their children Credit: Jenny Houghton
James Woodall with his son George in treatment at the Royal Marsden Centre Credit: Jenny Houghton
The NHS plans for the relocation to take place in October 2026 Credit: Harrison Galliven
Dr Chris Streather said: “This is a positive step forward for children’s cancer care.” Credit: Harrison Galliven
